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BMC Surg. 2017 Nov 28;17(1):111. doi: 10.1186/s12893-017-0314-y.

Incidence of orthostatic hypotension and cardiovascular response to postoperative early mobilization in patients undergoing cardiothoracic and abdominal surgery.

Author information

1
Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. mstshnd@nagasaki-u.ac.jp.
2
Department of Cardiopulmonary Rehabilitation Science, Unit of Rehabilitation Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
3
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
4
Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
5
Cardiorespiratory Division, Department of Rehabilitation Medicine, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
6
Division of Thoracic Surgery, Respiratory Disease Center, Seirei Mikatahara General Hospital, 3458 Mikatahara, Hamamatsu, 433-8558, Japan.
7
Department of Cardiovascular surgery, Nagasaki University Graduate School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
8
Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

Abstract

BACKGROUND:

In cardiothoracic and abdominal surgery, postoperative complications remain major clinical problems. Early mobilization has been widely practiced and is an important component in preventing complications, including orthostatic hypotension (OH) during postoperative management. We investigated cardiovascular response during early mobilization and the incidence of OH after cardiothoracic and abdominal surgery.

METHODS:

In this prospective observational study, we consecutively analyzed data from 495 patients who underwent elective cardiothoracic and abdominal surgery. We examined the incidence of OH, and the independent risk factors associated with OH during early mobilization after major surgery. Multivariate logistic regression was performed using various characteristics of patients to identify OH-related independent factors.

RESULTS:

OH was observed in 191 (39%) of 495 patients. The incidence of OH in cardiac, thoracic, and abdominal groups was 39 (33%) of 119, 95 (46%) of 208, and 57 (34%) of 168 patients, respectively. Male sex (OR 1.538; pā€‰=ā€‰0.03) and epidural anesthesia (OR 2.906; pā€‰<ā€‰0.001) were independently associated with OH on multivariate analysis.

CONCLUSIONS:

These results demonstrate that approximately 40% patients experience OH during early mobilization after cardiothoracic and abdominal surgery. Sex was identified as an independent factor for OH during early mobilization after all three types of surgeries, while epidural anesthesia was only identified after thoracic surgery. Therefore, the frequent occurrence of OH during postoperative early mobilization should be recognized.

TRIAL REGISTRATION:

University hospital Medical Information Network Center (UMIN-CTR) number UMIN000018632 . (Registered on 1st October, 2008).

KEYWORDS:

Cardiothoracic and abdominal surgery; Cardiovascular responses; Early mobilization; Orthostatic hypotension

PMID:
29183368
PMCID:
PMC5704500
DOI:
10.1186/s12893-017-0314-y
[Indexed for MEDLINE]
Free PMC Article

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